1331 – Review of archival tissue for further diagnostic testing

New MBS item.

The proposed medical service is the review of archival tissue by a pathologist to select appropriate tissue samples, predominantly cancer tissues, for further testing or pathological review.

For example biomarker testing on cancer tissue e.g. of currently MBS-approved EGFR testing for which the fee only reimburses the assay itself, or retrieval of tissues for second opinions in complex or rare cancers.

Type: Investigative

Advances in genetics and pharmacogenomics have resulted in a burgeoning array of targeted therapies based on specific ‘typing’ of the condition by a pathologist resulting in better management. For instance treatment is often matched to a particular mutation in that patient’s cancer. This may mean re-testing tissue that was collected at a previous biopsy/surgery or tissue collected from affected relatives. Occasionally, the original tissue is collected at a place (eg regional/remote or non-specialist centres) or at a time when these tests cannot be performed or before a particular therapy is necessary or available. Pathologists are being increasingly asked to review archival tissue specimens (blocks/slides) from patients with previous cancer diagnoses in order to select appropriate material to send for specialised biomarker testing to facilitate individualised therapy. This review (the proposed medical service) is currently unfunded.

• PASC meeting: 13-14 August 2015
• ESC meeting: 6 October 2016
• MSAC meeting: 
  • 24 - 25 November 2016
  • 6 - 7 April 2017